DO NOT DETACHX / \ > DO NOT DETACH
ENTRY BLANK
PLEASE TYPE OR PRINT
Entered previous May Show
U
n Ms.
^ Mr. Artist.
Permanent
Address
^Kyes L_
S. J~ Adson IOiIcdv.
□ no
Name Last)
'Atne svi ik ,
j>/4/ Pa
t jHol 7 St eet Tei. g/4) 3b Z' 1 3 L \ TyUos)
Afi Uke we CeM/gs^e,
3/^ | k ). UfasU^fttoiA. j ftuv\ J t lie
Zip
Temporary or
Studio Aridressj ^ I yLJ *
Street I ~ City
07*7 Tei.iao,) 3ra jjm (k jq^t)
Zip
Area Code
If you do not presently live in one of the counties of the
Western Reserve, which county were y<*u born in? .
Collaborator .
(If Any)
If IV^y Show entries are not accepted or not sold:
Artist will pick up at Museum.
□ Museum should dispose of.
□ Museum should ship to artist C.O.D. at this add/ess:
Special Instructions
When necessary include below instructions or a drawing of
how the object is to be assembled and displayed.
This entry blank must be fully made out and signed. Unsigned
entry blanks will not be accepted.
Note carefully calendar for delivery and return of objects. It is
understood that the Museum will have the right to dispose for
its own account any objects not called for by the dates listed.
It is also understood that accepted objects will remain on
exhibition until May 30, 1982.
submission o^objects will be construed as acceptance of
condi tior/Trinteckjn th^ptr^infgj;m^on.
Signature
The
,/all ci
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ENTRY
Ji
□ J . Paintings □ 2. Graphics LU 3. Photography
4. Sculpture □ 5. Crafts
Materials
C4ST CC&fyVc.
Title
Z)oc.c Idrt&o/O
. Price or NFS
(
Insurance VaJjue
if NFSp«^
\n.s\ !L
Ju ^
GRAPHICS AND PHOTOGRAPHY ONLY
Additional No.
For Sale
Total No. in Edition
Price
Unframed
Price of
Frame
ACCEPTED
DO NOT WRITE IN THIS SECTION
ACCEPTED
REJECTED
REJECTED
A
□ J. Paintings □ 2. Graphics □ 3. Photography
^3^4. Sculpture □ 5. Crafts
Materials
C#S7~ CZZ'fo'tics
Title
£rice or NFS
Insurance Value
Size
rf fro ■ — *
If NFS Ox\V^y
jaix h l*
GRAPHICS AND PHOTOGRAPHY ONLY
Additional No.
Total No. in Edition
Price
Price of
For Sale
Unframed
Frame
ACCEPTED
RECEIVED
yC
/
REJECTED
DATE
ACfr^T ED
REJECTED
DO NOT WRITE IN
THIS SECTION
